Age related adaptations in postural control after balance perturbations by simulating a ‘near fall’

- candidate number

15396

- NTR Number

NTR4170

- ISRCTN

ISRCTN wordt niet meer aangevraagd.

- Date ISRCTN created

- date ISRCTN requested

- Date Registered NTR

10-sep-2013

- Secondary IDs

NL43581.042.13 CCMO

- Public Title

Age related adaptations in postural control after balance perturbations by simulating a ‘near fall’

- Scientific Title

Age related adaptations in postural control after balance perturbations by simulating a ‘near fall’

- ACRONYM

- hypothesis

Falls are one of the greatest concerns among the elderly, because the incidents are high and they lead to severe consequences. The extent of the problem will continue to expand as the number of older people is expected to increase dramatically over the next few decades. An important risk factor for falls in the elderly is an impaired postural control, which is defined as the act of maintaining, achieving or restoring a state of balance during any posture or activity. A growing number of studies show the potential of video games incorporating training (exergames) to improve postural control. However, scarce evidence is available that these interventions actually contribute to a decrease in fall risk. Finding indicators for improved postural control are needed in order to be able to validate fall risk interventions. By studying age related postural adaptations to perturbations that challenge balance in a controlled environment like CAREN (Computer Assisted Rehabilitation Environment) insight into these indicators can be gained. Eventually these findings can be used for validating an exergaming training intervention in terms of reducing fall risk by improving postural control.
The main objective of the present study is to gain insight into factors that indicate an improved postural control by evaluating balance recovery (in terms of centre of mass (CoM) and centre of pressure (CoP)) of both young and older adults during a reaching task while exposed to perturbations of physical, visual or cognitive factors, causing a near fall.

Adults aged between 20 and 90, who are able to walk 200 m without aids (to a nearby shop), understand verbal instructions and have the visual ability to perceive the information presented on a large screen.

- Exclusion criteria

Young or elderly subjects who are not able to walk without aids, with orthopaedic or neurological disorders which prevent them for standing and reaching, have visual or hearing deficiencies that prevent them from perceiving or hearing presented information or/and have cognitive impairments that prevent them from understanding the instructions.

- mec approval received

no

- multicenter trial

no

- randomised

no

- group

[default]

- Type

Single arm

- Studytype

observational

- planned startdate

23-sep-2013

- planned closingdate

22-sep-2014

- Target number of participants

135

- Interventions

Both young and older participants will perform multiple target-directed weight shifting movements, i.e. reaching tasks, in three simulated fall risk situations which are divided in three experiments. The experiments will be conducted in the CAREN (Computer Assisted Rehabilitation Environment) lab. In the first experiment mechanical perturbations will be created by sudden platform translations with different velocity profiles during the performance of multiple reaching tasks. In the second experiment visual surround manipulations will be applied by projecting optic flow patterns on a large screen in front of the subjects during the performance of multiple reaching tasks. In the third experiment participants will perform a continuous cognitive demanding dual task during the performance of multiple reaching tasks

Clinical Balance test: The Narrow Ridge Balance Test (NRBT) to assess balance performance in elderly.
The adapted Dutch version of the Incidental and Planned Exercise Questionnaire (IPEQ) for older people to measure average weekly physical activity over the past 3 months of the elderly.

- Timepoints

Data from VICON (Motion capture system) and force plates will be collected during the experimental trials. The NRBT and the IPEQ will be completed before the experimental trials start.

The aim of this study is to gain insight into factors that indicate an improved postural control. Therefore adults aged between 20 and 90 will perform reaching tasks while at the same time a fall is simulated in a controlled virtual environment (CAREN). The fall will be simulated by applying either mechanical, visual or cognitive perturbations. The findings will be used to develop a virtual environment (VE) to evaluate balance recovery reactions.